Posterior Leg and Ankle Joint Flashcards
Posterior Aspect of the Leg Bones
Muscles of the Posterior Compartment
7 muscles (3 superficial, 4 deep)
Superficial muscles all insert on posterior surface of calcaneous via Tendocalcaneous
Tendons of deep muscles pass behind medial malleolus to plantar surface of foot (except popliteus)
Superficial Muscles - Gastrocnemius
Attachments (Medial and Lateral head)
Medial head: Popliteal surface of the femur, superior to the medial condyle
Lateral Head: Lateral aspect of the lateral condyle of the femur
Superficial Muscles - Gastrocnemius
Innervation
Tibial nerve (S1, S2)
Superficial Muscles - Gastrocnemius
Function
Plantarflexes ankle and flexes knee
Superficial Muscles - Plantaris
Attachments
Lateral supracondylar line of femur (proximal to the lateral head of gastrocnemius)
Superficial Muscles - Plantaris
Innervation
Tibial nerve (S1, S2)
Superficial Muscles - Plantaris
Function
Assists plantarflexion of ankle
Superficial Muscles - Soleus
Attachments
Soleal line of Tibia, upper 1/3 of posterior fibula. Tendinous arch between bony attachments
Superficial Muscles - Soleus
Innervation
Tibial nerve (S1, S2)
Superficial Muscles - Soleus
Function
Plantarflexes ankle joint
Deep Muscles - Popliteus
Attachments
Lateral condyle of the femur (pit for popliteus) and lateral meniscus to the popliteal area of the tibia (above the soleal line)
Deep Muscles - Popliteus
Innervation
Tibial nerve (L4, L5, S1)
Deep Muscles - Popliteus
Function
Unlocks the knee joint by laterally rotating the femur on the fixed tibia
Deep Muscles - Flexor Digitorum Longus
Attachments
Posterior surface of Tibia to the base of the distal phalanx of digits 2-4
Deep Muscles - Flexor Digitorum Longus
Tibial nerve (L5, S1, S2)
Deep Muscles - Flexor Digitorum Longus
Function
Flexes lateral 4 digits. Weak plantarflexor of ankle.
Deep Muscles - Flexor Hallucis Longus
Attachments
Posterior surface of Fibula to the base of the distal phalanx of the hallux
Deep Muscles - Flexor Hallucis Longus
Innervation
Tibial nerve (L5, S1, S2)
Deep Muscles - Flexor Hallucis Longus
Function
Flexes Hallux and is a weak plantarflexor of the ankle
Deep Muscles - Tibialis Posterior
Attachments
Posterior surface of tibia and fibula, and the inerosseous membrane to the tuberosity of the navicular, cuneiforms, cuboid, sustentaculum tali of calcaneus, and the base of the 2nd, 3rd and 4th metatarsals
Deep Muscles - Tibialis Posterior
Innervation
Tibial nerve (L4, L5)
Deep Muscles - Tibialis Posterior
Function
Plantarflexes ankle and inverts foot
Tendons of the Deep Muscles
Tibialis Posterior
Tendon passes deep to Flexor Digitorum Longus.
Groove posterior to the medial malleolus
Tendons of the Deep Muscles
Flexor Hallucis Longus
Grooves the posterior surface of the lower end of the tibia, the posteror surface of the talus
Tendons of the Deep Muscles
Arrangement of tendons at the ankle joint from medial to lateral:
Tibialis Posterior
Flexor Digitorum Longus
Flexor Hallucis Longus
Tom, Dick and Harry
Flexor Retinaculum
Path
Posterior tibial vessels/nerve
Medial malleolus to calcaneous
Found between FDL and FHL tendons
Arteries of Posterior Leg
Posterior Tibial Artery
Terminal branch of popliteal artery between heads of gastrocnemius and deep to soleus to run on surface of TP and FDL.
Gives fibular artery as a branch and terminates and medial and lateral plantar arteries in the foot.
Arteries of Posterior Leg
Fibular artery
Runs medial to the fibula - usually within FHL
Nerves of the Leg
Tibial Nerve
Route and Branches
Passes between heads of gastrocnemius and deep to tendinous arch of soleus. Between FHL and FDL at ankle joint.
Terminal branches that supply sole of foot - medial and lateral plantar nerves.
Cutaneous innervation of leg
Inferior Tibiofibular Joint
Ankle Joint
Malleolar Mortise
Formed from distal ends of tibia and fibula. Articulates with trochlea of talus
Capsule and Ligaments
Attachments, weak points and support
Around articular margins. Anteriorly extends onto neck of talus
Weak anteriorly and posteriorly
Supported laterally and medially by strong Collateral Ligaments
Lateral Collateral Ligaments
Red
Green
Blue
Anterior Talofibular to the neck of the talus
Posterior Talofibular to the lateral tubercle of the talus
Calcaneofibular to the lateral surface of calcaneous
Medial Collateral Ligament (deltoid)
Fans out from medial malleolus and has 4 parts
1) Anterior Tibiotalar
2) Tibionavicular
3) Tibiocalcaneal
4) Posterior Tibiotalar
